DR. KALPANA SURESH
The use of traditional eye medicines is an important factor in corneal blindness.
The cornea is the transparent layer in front of the eyeball. Its function includes protection of the eye, transmission of light and focusing light rays inside the eye. Diseases affecting the cornea lead to loss of transparency. This results in reduced vision and corneal blindness.
Eye diseases affecting the cornea are a major cause of blindness worldwide. The causes are complicated and encompass a wide variety of infectious and inflammatory diseases that cause scarring. This ultimately leads to functional blindness.
Important factor
In rural areas people tend to treat eye problems with traditional remedies. The use of traditional eye medicines (TEM) is an important factor in corneal blindness in many developing countries.
TEMs are used for a variety of eye diseases. Often, the result is a more complicated clinical picture because the remedy may cause more harm to an already abnormal eye. Measles is one example of a common infective condition where TEM may so worsen the clinical picture.
In deciding whether the patient’s eye has been influenced by TEM, the history is important. Also the patient may be reluctant to admit that TEM has been used realising that the health worker will generally not approve.
Most TEM consist of dried plant material crushed to powder and dissolved in water. Traditional healers use a variety of substances like juice of plant leaves, lime juice, kerosene, oils, toothpaste, cow dung, breast milk and urine (either animal or human).
These offer excellent opportunities to introduce pathogenic organisms into eyes already compromised by injury or infection. Some may cause a chemical or caustic reaction; others may introduce infection, such as bacterial or fungal infection from plant materials.
An unusual appearance of an eye, which does not seem to have a typical clinical appearance, together with an accurate history, will help in diagnosis.
Public health problem
The use of TEM is a public health problem throughout the developing world. Educating traditional healers and eliciting their cooperation in directing patients to appropriate healthcare facilities is a first step in preventing complications.
Many patients use traditional eye medicines on their own. This may be due to the cost of services, the distance involved in visiting clinics, or possibly an inherent bias. Factors associated with self-treatment include older age, illiteracy, poverty and ignorance.
The use of traditional medicines on the injured eye is likely to be associated with a very poor visual outcome. An intensive awareness campaign on the dangers of using traditional medicines on injured eyes is necessary. Traditional healers should also be integrated into the modern health system to use their abilities and control their practices.
Medical and especially surgical intervention is not cost-effective in eliminating corneal blindness in developing countries. Prevention, in the case of almost every disease involved, is more cost-effective and ultimately more successful in decreasing the prevalence of blindness.
The writer is an Associate Professor and Consultant Ophthalmologist based in Chennai.